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efta-01380838DOJ Data Set 10Other

EFTA01380838

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DOJ Data Set 10
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efta-01380838
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EFTA Disclosure
Text extracted via OCR from the original document. May contain errors from the scanning process.
II. Certification of beneficial owner(s) Persons opening an account on behalf of a legal entity must provide the following information: a. Name and Title of Natural Person Opening Account: i t JEFFREY E. EPSTEIN, MANAGER b. Name of Legal Entity Type of Legal Entity, and Address of Legal Entity for Which the Account Is Being Opened: (SOUTHERN FINANCIAL, LLC, A USVI LIMITED LIABILITY COMPANY 16100 RED HOOK QUARTER, B3 i St THOMAS, USVI 00802 I c. The following information for each individual, if any, who, directly or indirectly, through any contract, arrangement. understanding, relationship or otherwise, owns 25 percent or more of the equity interests of the legal entity listed above: Name Date or Birth lets) Address For (LS, PerS0os: Such Security Number For tion-th& Persons: (See footnote 1 for alternatives to Social Seargy hkenberl JEFFREY E. EPSTEIN 1/20/53 6100 RED HOOK QUARTER, B3 St THOMAS, USVI 00802 11 L For Non-U.S. %Sena, in additiontoa Social Sacvnly Number or a Passport Number with Country0 issuance. an alien rdentikation card lumber, (X number and country of issuance of any ether guvemmenoissued decurnent evidencing nationality or residence and bearing a photograph or similar safeguard should be nravideci. (If no individual meets this delinibon 0leave unite "Not Amicable) d. The following information for one individual with significant responsibility for managing the legal entity listed above, such as: • An executive officer or senior manager (e.g., Chief Executive Officer, Chief Financial Officer. Chief Operating Officer, Managing Member, General Partner, President, Vice President Treasurer); or • Any other individual who regularly performs similar functions. (If appropriate, an individual listed under section (c) above may also be listed in this section (d)), Name 1. Data of Sins I Legal Address €For.U.S.Perscms. , Statim r rty ABOVE JEFFREY E. EPSTEIN SEE 1 For Non.US. persons. in addition to a Social Security Wilmer or o Passport Number rrith Country or Issuance, an alien kienrilicason Care number. or number end entintry of iS2.43flet Cd any other governmenoiseued document Or:A:lancing nationality or !riddance and bearing a photograph or simSar safeguard should be provided. Pa- Nos-U.S. Persons: (See footnote I hr alternatives! to Soder Security Number) I FFREY E. knowledge, the STEIN the informat me of natural person opening the account), hereby certify, to the best of ed above is complete and correct. Signature Legal Entity Sterna*: (Optional) 7/24/18 Date CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) CONFIDENTIAL DB-SDNY-0079399 SDNY_GM_00225583 EFTA01380838

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